Hyoid suspension is a procedure to stabilise the retrolingual space in obstructive sleep apnoea. Using the Hörmann technique, a steel wire is slung around the body of the hyoid and fixed to the upper rim of the thyroid cartilage. It was observed, however, that the steel wire may lie very superficially to the pharyngeal mucosa. Evaluation of computed tomography (CT) scans showed a mean distance between the hyoid and the pharynx of only 3 mm. A modification is presented by threading a steel wire through a hole that is drilled through the hyoid bone. Thus pharyngeal exposure of the steel ligature and possible perforation of the mucosa is avoided.

We report the case of a 26-year-old man who presented to us with dysphagia secondary to blunt trauma to the neck. The patient was found to have a hyoid bone fracture with pharyngeal perforation and resultant neck abscess. The patient responded to prompt surgical and medical management. We believe this to be the first report of such a case.

We present a unique case of a mucin-secreting papillary adenocarcinoma of intestinal type which has invaded and completely destroyed the hyoid bone and metastasized to the cervical lymph nodes bilaterally. The tumour is believed to have originated from a malignant thyroglossal duct remnant, and was managed with surgery and radiotherapy. We describe the case and discuss the literature regarding hyoid bone tumours.

Osteoradionecrosis of the hyoid has been reported rarely in the worldwide literature. We present the case of a 56-year-old gentleman who presented with intractable neck pain, following surgery and radiotherapy for a T2N2cM0 tongue base carcinoma, to highlight the need to consider osteoradionecrosis of the hyoid rather than recurrence of the carcinoma as the cause of such symptoms. The previously unreported appearance of osteoradionecrosis of the hyoid on a magnetic resonance image (MRI) scan and the use ofthis investigation to aid diagnosis is discussed.

An atypically sited thyroglossal cyst in a 69-year-old woman is described in this report. The cysts may be located in the intralingual, suprahyoid, thyrohyoid or suprasternal region. The intrahyoid location is rare. The diagnosis was confirmed by computed tomography (CT). Surgical procedure should be indicated in intrahyoid thyroglossal duct cyst cases.

Giant cell tumours of bone are most commonly found in the epiphyses of weight-bearing long bones. They are rarely found in the head and neck and only 17 cases involving the laryngeal framework have been reported. To date, there have been no reports of a giant cell tumour arising from the hyoid bone. We present such a case which presented as a lump overlying the greater cornu of the hyoid, review the literature and discuss the management of this locally aggressive tumour.

A patient complaining of pain and noise on turning her neck was diagnosed as having a large greater cornua of the hyoid bone. Excision of the greater cornua relieved the symptoms.

Fifty-one patients who presented with anterior cervical or throat pain, without apparent cause, were selected for study at the ENT outpatient department from January 1987 to January 1992. Their clinical symptoms, probable aetiologies and treatment were studied. The most common diagnosis was hyoid syndrome, followed by thyroid cartilage syndrome and cricoid cartilage syndrome. These last two syndromes have not been previously reported because they were coined in Ramathibodi Hospital for patients who had similar clinical patterns localized to the thyroid and cricoid cartilages respectively. Treatment using intralesional triamcinolone acetonide injection was effective in all cases. There was no recurrence after one-five years follow-up.

This paper reports on 13 patients with a pain syndrome arising from the region of the greater cornu of the hyoid bone. It is often missed and yet is readily treatable. The syndrome causes pain on swallowing in the region of the hyoid which may radiate to the ear, face and lower jaw or may be felt also in the pharynx. Treatment by an injection of a mixture of depomedrone and one per cent lignocaine is very effective.

The underlying pathology is discussed and it is suggested that in some cases the pain and discomfort experienced by patients may be due to tenosynovitis of the intermediate tendon of the digastric muscle. Greater recognition of this relatively common condition would not only result in more effective treatment but would also avoid unnecessary investigation and surgery.

A case of plasmacytoma arising from the hyoid bone is described, this is a distinctly unusual site, as the marrow-containing flat bones are more commonly affected. On a review of the literature this appears to be the first report of plasmacytoma occurring in the hyoid bone. The patient underwent a CT scan and plain radiographs. Histopathology was diagnostic.

We report a case of a partly ossified thyroglossal cyst in close proximity to the hyoid bone and discuss the possible embryological significance of this. Thyroglossal cysts occurring within the hyoid bone or deep to the hyoid periosteum support previous suggestions that the thyroglossal tract can sometimes be trapped within the developing hyoid bone.

This paper presents a quite unique case report of a patient presenting with the combination of cervical metastatic lymphadenopathy and a hyoid bone tumour mass. The differential diagnosis and treatment is discussed, with emphasis on the importance of immunohistochemistry and electron microscopy in the management of such a case.

Chondrosarcoma of the head and neck is relatively rare. We report the sixth case known to us in which the chondrosarcoma had originated in the hyoid bone. The patient, a 66-year-old man, underwent surgery. The resected tumour was a 5 cm encapsulated lesion composed of lobulated, firm, gray-white tissue. Histologically it showed mature chondrocytes without capsular invasion. There was high cellularity and a few binucleated chondrocytes. Although the tumour grade was prognostic significance, our literature review of the five other cases suggests that the location of the primary lesion and the adequacy of its resection to be more important. Our patient continues to do well 15 months post-operatively. However, long-term follow-up is essential as recurrences have been reported even after eight or 10 years.

Two cases of chondrosarcoma of the hyoid bone are described. They were managed with surgical resection and postoperative radiotherapy. These patients are disease free at 26 months and 15 months respectively.

Aneurysmal bone cyst is a rare lesion usually of the long bones, well documented in the literature. It is a cystic, osteolytic vascular tumour, replete with giant cells and fibrous septa, yet devoid of endothelial lining. It has been reported in the larynx and maxillary sinus. This appears to be the first report Qf an aneurysmal bone cyst occurring in the hyoid bone.

A patient complaining of dysphagia was diagnosed as suffering from a fracture of the hyoid bone. The fracture was fixed using the modern technique of tension band wiring. There was subsequent relief of the symptoms. A review of the literature and our perspective is included.